Provider Demographics
NPI:1639293376
Name:GIANNI, PAMELA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:GIANNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S. CENTER AVE.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW STANTON
Mailing Address - State:PA
Mailing Address - Zip Code:15672-0477
Mailing Address - Country:US
Mailing Address - Phone:724-925-1826
Mailing Address - Fax:724-925-1827
Practice Address - Street 1:111 S. CENTER AVE.
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW STANTON
Practice Address - State:PA
Practice Address - Zip Code:15672-0477
Practice Address - Country:US
Practice Address - Phone:724-925-1826
Practice Address - Fax:724-925-1827
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD055206L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG219-56Medicare UPIN